NCMIC Chiropractic Malpractice Insurance Quick Quote - NCMIC | Malpractice Insurance - Financial and Insurance Products

Simply complete the information below.

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Step: 1 of 3

Personal and Practice Information

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*First Name:

Middle Initial:

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*Last Name:

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*Address:

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*City:

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*ZIP:

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*State:

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*Email:

Note: Your email address will never be sold. It will be used to send your malpractice insurance quote.

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*Phone:

(as xxx-xxx-xxxx)

Error: College Graduation Date is required. Error: Invalid Format.

*College Graduation Date:

(as mm/dd/yyyy)

Please keep in mind the rate(s) and coverage listed on your quick quote are subject to underwriting approval and not guaranteed. Rate(s) and coverage may change based on information you provide in the NCMIC Request for Chiropractic Malpractice Insurance. In addition, rates may be subject to change upon renewal.

To ensure all information has been recorded accurately and to be certain you receive every discount to which you are entitled, please call 1-800-769-2000 Ext. 3019 to talk to an NCMIC Client Representative.

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Coverage and Quote Information

Error: Expected Licensure Date is required. Error: Invalid Format. Error: Expected Licensure Date must be greater than College Graduation Date.

*Expected Licensure Date:

(as mm/dd/yyyy)

Error: Expected Practice State is required.

*Expected Practice State:

Error: Expected Practice County is required.

*Expected Practice County:

*Type of Coverage:

Claims Made Occurrence Both

Error: Policy Limits is required.

*Policy Limits:

Note: Limits of coverage are per claim/aggregate per policy year.

Please keep in mind the rate(s) and coverage listed on your quick quote are subject to underwriting approval and not guaranteed. Rate(s) and coverage may change based on information you provide in the NCMIC Request for Chiropractic Malpractice Insurance. In addition, rates may be subject to change upon renewal.

To ensure all information has been recorded accurately and to be certain you receive every discount to which you are entitled, please call 1-800-769-2000 Ext. 3019 to talk to an NCMIC Client Representative.

Simply complete the information below.

*Required field

Step: 2 of 3

Coverage and Quote Information

Error: Original Licensure Date is required. Error: Invalid Format. Error: Original Licensure Date must be greater than College Graduation Date.

*Original Licensure Date:

(as mm/dd/yyyy)

Error: Practice State is required.

*Practice State:

Error: Practice County is required.

*Practice County:

*Coverage Type:

Claims Made Occurrence Both

*Retroactive Coverage:

Yes No

Error: Retroactive Date is a required field. Error: Invalid Format. Error: Retroactive Date must be greater than College Graduation Date. Error: The date entered is a date in the future. Retroactive Date must reflect a past date.

*Retroactive Date:

(mm/dd/yyyy)

Error: Policy Limits is a required field.

*Policy Limits:

Note: Limits of coverage are per claim/aggregate per policy year.

Error: Hours Available for Patient Visits is required.

*Hours Available for Patient Visits Per Week:

(Professional services include examination, consultation, and adjustment as well as any time the patient spends with a chiropractic assistant or massage therapist.)

Error: Hours Available for Patient Visits is required.

*Hours Available for Patient Visits Per Week:

Error: Patient Visits is required.

*Patient Visits Per Week:

*Have you been continuously insured and claims free for the last 5 years?

Yes No

Please keep in mind the rate(s) and coverage listed on your quick quote are subject to underwriting approval and not guaranteed. Rate(s) and coverage may change based on information you provide in the NCMIC Request for Chiropractic Malpractice Insurance. In addition, rates may be subject to change upon renewal.

To ensure all information has been recorded accurately and to be certain you receive every discount to which you are entitled, please call 1-800-769-2000 Ext. 3019 to talk to an NCMIC Client Representative.

Step: 3 of 3

Successful Submission

Thank you for your interest in NCMIC's Chiropractic Malpractice Insurance Plan. You will receive an email with this same quote information at the email address you provided: .

Please keep in mind the rate(s) and coverage listed on your quick quote are subject to underwriting approval and not guaranteed. Rate(s) and coverage may change based on the information you provide in the NCMIC Request for Chiropractic Malpractice Insurance. In addition, rates may be subject to change upon renewal.

To ensure all the information is correct and you receive every discount to which you are entitled, please call 1-800-769-2000 Ext. 3019 to talk to an NCMIC Client Representative.

The information included in this quote is effective for 30 days from: Sunday, October 21, 2018.

Summary of Information

State:

County:

Policy Limits:

Coverage Type:

College Graduation Date:

Expected Licensure Date:

Discount Included

Your quote includes the 1st year licensure premium discount of 75%.

Premium Amount

Annual, semi-annual, quarterly (not avail. in CT) and tri-annual (only in CT) payment options are available.

In the state of Kansas there will be an additional premium to participate in the Kansas Healthcare Stabilization Fund. Please contact an NCMIC Client Representative at 1-800-769-2000 Ext. 3019 to receive a quote for participation.

Claims Made^*

Annual Premium:

*The premium for a Claims Made policy increases annually for the first five years of coverage. If coverage is retroactive to previous years, the retroactive date determines which of the first five premium years is applied.

Occurrence

Annual Premium:

Summary of Information

State:

County:

Policy Limits:

Coverage Type:

College Graduation Date:

Original Licensure Date:

Retroactive Date:

Discount Included

Your quote includes:

Other discounts may apply; please call 1-800-769-2000 Ext. 3019.

Premium Amount

Other discounts may apply; please call 1-800-769-2000 Ext. 3019.

Annual, semi-annual, quarterly (not avail. in CT) and tri-annual (only in CT) payment options are available.

In the state of Kansas there will be an additional premium to participate in the Kansas Healthcare Stabilization Fund. Please contact NCMIC to receive a quote for participation.

Claims Made^*

Annual Premium:

*The premium for a Claims Made policy increases annually for the first five years of coverage. If coverage is retroactive to previous years, the retroactive date determines which of the first five premium years is applied.

Occurrence

Annual Premium:

If you are ready to apply for coverage, or would like to request a quote for different limits of liability, see below.

Have More Questions?

NCMIC Client Representatives are available to answer any questions and help you take the next step. Please call us at 1-800-769-2000 Ext. 3019.

NCMIC's Chiropractic Malpractice Insurance Quick Quote

Summary of Information

Discount Included

Premium Amount

Claims Made*

Occurrence

Summary of Information

Discount Included

Premium Amount

Claims Made*

Occurrence

Have More Questions?

Claims Made^*

Claims Made^*